Abstract

Introduction: Primary lesions of the hyoid bone are exceedingly rare. This report would be the second case of a primary osteosarcoma (OS) of the hyoid bone ever reported. Case report: A 61-year old Ecuadorian woman noted an asymptomatic slowly growing mass in the upper part of neck two months before the first consultation on physical examination, a submental 6-cm, bilobulated, hard, fixed mass, extended to level IIA and the floor of the mouth, was found. Ultrasound, computed tomography and magnetic nuclear imaging reported a tumor probably originated in the hyoid bone. A wide excision, including the hypoglossal nerve, was performed, followed by eight courses of adjuvant chemotherapy, with cisplatin with doxorubicin. Pathological study revealed a high-grade conventional osteogenic sarcoma. No evidence of distant disease was found 2 years and 7 months after initial treatment. Discussion: A review of the literature was performed. Among the largest series of head and neck OS, no case of hyoid bone OS was described. Clinical presentation, imaging studies, surgical management and adjuvant radio and chemotherapy were discussed. Conclusion: A wide local excision of a hyoid bone OS and adjuvant chemotherapy allowed a survival of two and half years after treatment.

Highlights

  • This report would be the second case of a primary osteosarcoma (OS) of the hyoid bone

  • Magnetic nuclear imaging (MRI) reported a tumor probably originated in the hyoid bone, with slight invasion of the root of the tongue and of the larynx (Figure 1)

  • Head and neck OS occur in patients who are older than those with OS of the long bones, with a mean age of 36 years according to a meta-analysis of 178 patients [6]

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Summary

Introduction

Primary lesions of the hyoid bone are exceedingly rare. Reported malignant lesions include chondrosarcoma, plasmacytoma, and metastatic squamous cell carcinoma, and benign masses include aneurysmal bone cysts, chondromas, and osteomas [1]. This report would be the second case of a primary osteosarcoma (OS) of the hyoid bone. A 61-year old Ecuadorian woman noted an asymptomatic slowly growing mass in the upper part of neck two months before the first consultation. A computed tomography (TC) scan of the neck showed a 55x35x34mm, bilobulated mass, with peripheral calcifications and extended to the right carotid and. Magnetic nuclear imaging (MRI) reported a tumor probably originated in the hyoid bone, with slight invasion of the root of the tongue and of the larynx (Figure 1). Pathologic examination of the specimen showed a malignant neoplasia with proliferation of anaplastic A computed tomography (TC) scan of the neck showed a 55x35x34mm, bilobulated mass, with peripheral calcifications and extended to the right carotid and paraphryngeal spaces. A neck CT scan before her last office visit was negative and no evidence of distant disease was found 2 years and 7 months after initial treatment

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